Permit �. CITY OF TIGARD MASTER PERMIT
�. DEVELOPMENT SERVICES PERMIT # • MST98 -0397
' !J,141111 13125 SW HaII Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 10/06/96
PARCEL: 1S135CD -03601
SITE ADDRESS...:09625 SW LEWIS LN
SUBDIVISION •RUTH ZONING: R -4.5
BLOCK LOT •001 JURISDICTION: TIG
Remarks: Add new garage to an existing single family dwelling.
BUILDING - - - --
REISSUE: STORIES • 1 FLOOR AREAS BASEMENT...: 0 sf REQUIRED SETBACKS -- REQUIRED— --
CLASS OF WORK.:ADD HEIGHT • 10 FIRST • 0 sf GARAGE • 412 sf LEFT : 0 SMOKE DETECTRS:
TYPE OF USE...:SF FLOOR LOAD • 50 SECOND...: 0 sf FRONT • 20 PARKING SPACES: 0
TYPE OF CONST.:5N DWELLING UNITS: 0 FINBSMENT: 0 sf RIGHT • 5
OCCUPANCY GRP.:R3 BDRM: 0 BATH: 0 TOTAL 0 sf VALUE..$: 7560 REAR : 0
PLUMBING
SINKS • 0 WATER CLOSETS.: 0 WASHING MACH..: 0 LAUNDRY TRAYS.: 0 RAIN DRAIN ft: 0 TRAPS • 0
LAVATORIES • 0 DISHWASHERS...: 0 FLOOR DRAINS..: 0 SEWER LINE ft: 0 SF RAIN DRAINS: 1 CATCH BASINS..: 0
TUB /SHOWERS...: 0 GARBAGE DISP..: 0 WATER HEATERS.: 0 WATER LINE ft: 0 BCKFLW PREVNTR: 0 GREASE TRAPS..: 0
OTHER FIXTURES: 0
— MECHANICAL
FUEL TYPES FURN ( 100K ..: 0 BOIL /CMP ( 3HP: 0 VENT FANS • 0 CLOTHES DRYERS: 0
FURN ) =100K ..: 0 UNIT HEATERS..: 0 HOODS • 0 OTHER UNITS...: 0
MAX INP.: 0 BTU FLOOR FURNACES: 0 VENTS • 0 WOODSTOVES • 0 GAS OUTLETS...: 0
---- - -- ELECTRICAL - -
- RESIDENTIAL UNIT— — SERVICE /FEEDER— —TEMP SRVC /FEEDERS— — BRANCH CIRCUITS — — MISCELLAN:OUS— - -ADD'L INSPECTIONS -
1Y SF OR LESS: 0 0 - 200 amp..: 0 0 - 200 amp..: 0 W /SVC OR FDR..: 0 PUMP /IRRIGATION: 0 PER INSPECTION: 0
EA ADD'L 500SF.: 0 201 - 400 amp..: 0 201 - 400 amp..: 0 1st W/O SVC /FDR: 1 SIGN /OUT LIN LT: 0 PER HOUR • 0
LIMITED ENERGY.: 0 401 - 600 amp..: 0 401 - 600 amp..: 0 EA ADDL BR CIR: 1 SIGNAL /PANEL...: 0 IN PLANT : 0
MAW HM /SVC /FDR: 0 601 - 1.x' amp.: 0 601 +amps- 1m v: 0 . MINOR LABEL -10: 0
1000+ amp /volt.: 0 PLAN REVIEW SECTION
Reconnect only.: 0 )=4 RES UNITS..: SVC /FDR) =225 A.: ) 600 V NOMINAL: CLS AREA /SPC OCC:
--- ELECTRICAL - RESTRICTED ENERGY — --
A. SF RESIDENTIAL B. COMMERCIAL --
AUDIO & STEREO.: VACUUM SYSTEM..: AUDIO & STEREO.: FIRE ALARM • INTERCOM /PAGING: OUTDOOR LNDSC LT:
BURGLAR ALARM..: 0TH: :: BOILER HVAC LANDSCAPE /IRRIG: PROTECTIVE SIGNL:
GARAGE OPENER..: CLOCK INSTRUMENTATION: MEDICAL OTHR: ..
HVAC • DATA /TELE COMM.: NURSE CALLS • TOTAL D SYSTEMS: 0
Owner: Contractor: -- TOTAL FEES:$ 229.96
RICHARD B EATON, LINDA L OWNER This permit is subject to the regulations contained in the
9625 SW LEWIS LANE Tigard Municipal Code, State of Ore. Specialty Codes and all
TIGARD OR 97223 other applicable laws. All work will be done in accordance
with approved plans. This permit will expire if work is
Phone 0: Phone D: not started within 180 days of issuance, or if the work is
. Reg D..: suspended for more than 180 days. ATTENTION: Oregon law
-- requires you to follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth in OAR 952-001 -0010 through OAR 952-001-0080. You may obtain copies of these rules or
direct questions to OUNC by calling (503)246 -1987.
REQUIRED INSPECTIONS
Erosion 844 -8444 Rain drain Insp
Footing Insp Building Final
Foundation Insp
Framing Insc-4-4-+
Shear Wall _
Issued AL Wirlfi #e„,/ Permittee Si gnature: + + + + + + +++++++++++++++++++++++++++++++++ + + + + + + + + + + + + + + + + + + + + + + + + + + + + + ++
Call 639 -4175 by 7:00 p.m. for an inspection needed the next business day
/0- (a- C O Plan Check # 6 / — a _
CITY OF TIGARD Residential Building Permit Application Rec'd By
131 SW BLVD. New Construction Additions or Alterations Date Recd
TIGARD, OR 97223 Single Family Detached or Attached (Duplex) Date to P.E. Y- q--
V 503 - 639 -4171 Date to DST / G -6‘-97
F 503 -684 -7297 Permit # /715r9 F - °347
\Ai Print or Type Called /0' 1.6-Pr" 0-92r— �—
I ncomplete or illegible applications will not be accepted 1.6-Pr" lIF9
Q` b*/ /r!/Pcfle _
Name of Project Aef rA C C" / Name
Job 2itM9 P Y 2/)pi9L
Address to Address Architect Mailing Address
City /State Zip Phone
\ -44-\-\ \NV✓ C c, Name
Owner Mailing Address
\:. �-c S�e .N. 5
Ci /State Zip Phone Engineer Mailing Address
` 1
- N.c� 0,540 `k c(\'L'L N
`1 City /State Zip Phone
N ame
General _
Contractor STh -, ` _ � p -4--- Describe work New 0 Addition 0 Alteration 0 Repair 0
Mailing Address ' to be done:
Prior to permit \j■s Additional Description of Work:
issuance, a copy City /State Zip Phone
of all licenses
are required if Oregon Const. Cont. Board Exp. Date PROJECT � ��
expired in COT Lic.# VALUATION 0;0
database
• Mechanical Name NEW CONSTRUCTION ONLY:
Sub- Sq. Ft. House: l<7.1. Ft. ara e // Contractor Mailing Address
Prior to permit Corner Lot YES NO Flag Lot YES NO
issuance, a copy City /State Zip Phone (check one) (check one)
of all licenses Restricted Audio /Stereo Burglar
are required if Oregon Const. Cont. Board Exp. Date Energy System Alarm
expired in COT Lic.#
database Installation Garage Door HVAC
Plumbing Name Opener Systems
Sub- (check all that Other.
-
Contractor Mailing Address apply)
Will the electrical subcontractor wire for all YES NO
restricted energy installations?
Prior to permit City/State Zip Phone Has the Subdivision Plat recorded? N/A YES NO
issuance, a copy
of all licenses are Oregon Const. Cont. Board Exp. Date -
required if Lic.# Solar Compliance
expired in COT (Calculation Attached)
database Plumbing Lic. # Exp. Date I hearby acknowledge that I have read this application, that the
information given is correct, that I am the owner or authorized
Name agent of the owner, and that plans submitted are in compliance
with Oregon State laws.
Electrical 6 v —� i n of Offer/ gent Date,
Sub- Mailing Address �� -- � � 'A D
Contractor on ct `Pers n Name - c:..,\-- Phone # _
City/State Zip Phone -\\� b - 4 -- -- 1 0a 0-- A \ \ - -:
Prior to permit FOR OFFICE USE ONLY:
issuance, a copy Plat #: Map/TL #:
of all licenses are Oregon Const. Cont. Board Exp. Date , ro - 3 e'/
required if Lic.# s 13seD
expired in COT Setbacks: Zone' Lf Solar::
database Electrical Lic. # Exp. Date r 5
_ Engineering Approval: _ Planning Approval: TIF:
I:SFREM.DOC (DST) 4/97
r
Permit #: AO r' -o3 % 7
A Address: 9 Ga s GJ
,
%.`,47.',.1.;1.: Issued by: Date:
i 5 g ,
Statement: Information Notice to Property Owners
About Construction Responsibilities
Note: Oregon Law, ORS 701.055(4), requires residential construction permit appli-
cants who are not registered with the Construction Contractors Board to sign the
following statement before a building permit can be issued. This statement is required
for residential building, electrical, mechanical, and plumbing permits. Licensed
architect and engineer applicants, exempt from registration under ORS 701.010(7),
need not submit this statement. This statement will be filed with the permit.
Fill in the appropriate blanks and initial boxes 1 and 2,1nd either box 3A or 3B:
11 1. I own, reside in, or will reside in the completed structure.
-+El 2. I understand that I must register as a construction contractor if the structure is sold or offered for sale
before or upon completion.
n 3A. My general contractor is
I I (Name) Contractor regis. #
I will instruct my general contractor that all subcontractors who work on the structure must be
registered with the Construction Contractors Board.
OR
n 3B.. I will be my own general contractor.
If I hire subcontractors, I will hire only subcontractors registered with the Construction Contractors
Board. If I change my mind and hire a general contractor, I will contract with a contractor who is
registered with the CCB and will immediately notify the office issuing this building permit of the
name of the contractor.
I hereby certify that the above information is correct and that I have read and do understand the Information
Notice to PPro perty Owners about Construction Responsibilities on the reverse side of this form.
-1( R...k „% , \ Z. —k) -- cl
(Signature of permit applicant) _ _ (Date)
(White copy to issuing agency permit file,
pink copy to applicant)
N Info Notice to Property Owners
About Construction Responsibilities
•
Note: Thi., li rmc: Notice to Property Owners about Construction Responsibilities
,vas de:el'ir Jl y the Construction Contractors Board in accordance with ORS 701.055(5).
If you are acJng as 3 oiir ow. , :nitre.{ 'or to construct u new home o: make a substantial improvement to an existing structure,
you can pre: en_ many prohiLn_r by being aware of the following responsibilities and areas of concern.
EMPLOYER RESPONSIBILITIES:
If yon hire persons not re gis r!ed with the Construction Contractors Board to do labor in constructing or assisting in the
constr iction or impro eoiew ci a re structur: you will, in most instances, be ruled to be an employer and the people
you hire will he employees. A. the L;mployer, you must comply with the following:
Oregon's withholding tax lay.: As un employer, you must withhold income taxes from employee wages at the time employees
are paid. You will be liable fri the tax payments even if you don't actually withhold the tax from your employees. For more
information, call the Oregon Dept. of Revenue at 945 -8091.
Unemployment insurance As an employer, you are required to pay a tax for unemployment insurance purposes on the
wages of all employees. Foy' ;,:,'re information, call the Oregon Employment Division at the Department of Human Resources
at 378 -3524.
Workers' compensation insurance: As an employer, you are subject to the Oregon Workers' Compensation Law, and Must
obtain workers' compensation insurance for your employees. If you fail to ohtain workers' compensation insurance, you may
be subject to penalties 4nd will he liable for all claim costs if one of your employees'is injured on the job. For more information,
call the Workers' Cornpensa[ion Division at the Department of Consumer and Business Services at 945 -7888.
U.S. Internal Revenue Service: As an employer, you must withhold federal income tax from employees' wages. You will be
liable for the tax payment even if you didn't actually withhold the tax. For more information, call the Internal Revenue Service
at 1-800-829-1040.
OTHER RESPONSIBILITIES AND AREAS OF CONCERN:
Code compliance: As the permit holder for this project, you are responsible for resolving any failure to meet code requirements
that may be brought to your attention through inspections.
Liability and property damage insurance: Contact your insurance agent to see if you have adequate insurance coverage for
accidents and omissions such as falling tools, paint overspray, water damage from pipe punctures, fire, or work that must be
re -done.
Time to supervise employees: Make sure you have sufficient time to supervise your employees.
Expertise: Make sure you have the expertise to act as your own general contractor, to coordinate the work of rough -in and finish
trades, and to notify building officials at the appropriate times so they can perform the required inspections.
If you have additional questions, write or call the Construction Contractors Board (PO Box 14140, Salem, OR 97309 -5052,
503/378- 4621). The Board is located at 700 Summer St. NE Suite 300, in Salem.
prop- own.pm4
1/94
CITY OF TIGARD BUILDING INSPECTION DIVISION Msr -0397
24 -Hour Inspection Line: 639 -4175 Business Line: 639 -4171
q BUP
Date Requested S 5-'79 AM PM BLD
Location C iCP 25 (Iitio /� Cr)- Suite MEC
Contact Person (___Hi , ) ?L' Ph (o21)'2-6 PLM
Contractor Ph SWR
$UILI Tenant/Owner ELC
Retaining Wall ELR
Footing Access:
Foundation G� r C FPS
Ftg Drain " l J SGN
Crawl Drain Inspection Notes:
Slab SIT
Post & Beam
Ext Sheath /Shear
Int Sheath /Shear
Framing is •P L
Insulation r 4 /
Drywall Nailing i<_ I Ltd - - Ad .
Firewall / / i
Fire Sprinkler
Fire Alarm
Susp'd Ceiling
Roof
IffSt'w
PART FAIL
• ' BING
Post & Beam
Under Slab
Top Out
Water Service
Sanitary Sewer
Rain Drains
Final
PASS PART FAIL
MECHANICAL
Post & Beam
Rough In
Gas Line
Smoke Dampers
Final
PASS PART FAIL
ELECTRICAL
Service
Rough In
UG /Slab
Low Voltage
Fire Alarm
Final
PASS PART FAIL
SITE
Backfill /Grading
Sanitary Sewer
Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd
Catch Basin
Fire Supply Line [ ] Please call for reinspection RE: [ ] Unable to inspect - no access
- -- ADA -- — — —
Approach /Sidewalk Date Inspector C t
D
Other P Ext
Final
PASS PART FAIL DO NOT REMOVE this inspection record from the job site.